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Critical errors found during metered dose inhaler technique demonstration by Pharmacists
Saudi Pharmaceutical Journal (2015) xxx, xxx–xxx
King Saud University
Saudi Pharmaceutical Journal www.ksu.edu.sa www.sciencedirect.com
Critical errors found during metered dose inhaler technique demonstration by Pharmacists It is extremely important to demonstrate the standardized recommended technique (Adnan et al., 2014) of metered dose inhaler to the patients. Many studies have found critical errors made by pharmacists during demonstration of metered dose inhaler technique (Adnan et al., 2014; Osman et al., 2012; Lenney et al., 2000). The critical errors are those missing steps that have significant effect on aerosol drug delivery (Osman et al., 2012; Lenney et al., 2000). Missing these critical steps can lead to either little or no drug delivery to the target point (Lenney et al., 2000). Moreover, many studies have shown that as many as 25% of patients with asthma and COPD have never received verbal inhaler technique instruction (Javorini et al., 2008). The following critical steps have been found missing by pharmacists during demonstration of metered dose inhaler technique (Adnan et al., 2014; Osman et al., 2012; Lenney et al., 2000). Shake inhaler and remove the cap. Insert the mouthpiece into mouth between closed lips. Actuation in the first half of inhalation and at the same time breathe in slowly for deep inhalation. Hold breath for 10–15 s. These critical errors have been associated with increase in emergency visits, and worsening asthma (Giraud and Roche, 2002). Pharmacists are ideally positioned to teach inhaler technique as they are the last health-care providers however; they should review their inhalation technique and must be fully aware of appropriate recommended steps of using metered dose inhaler.
References Adnan, M., Karim, S., Khan, S., Al-Wabel, N.A., 2014. Comparative evaluation of metered-dose inhaler technique demonstration among community pharmacists in Al Qassim and Al-Ahsa region, Saudi-Arabia. Saudi Pharm. J. http://dx.doi.org/10.1016/ j.jsps.2014.06.007. Javorini, F., Magnan, A., Dubus, J.C., et al., 2008. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Resp. Med. 102, 593–604. Lenney, J., Innes, J.A., Crompton, G.K., 2000. Inappropriate inhaler use: assessment of use and patient preference of seven inhalation devices. Resp. Med. 94 (5), 496–500. Giraud, V., Roche, N., 2002. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur. Resp. J. 19, 246–251. Osman, A., Ahmed Hassan, I.S., Ibrahim, M.I.M., 2012. Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study. Pharm. Pract. (Internet) 10 (2), 110–115.
Muhammad Adnan * Shahid Karim Shamshir Khan Naser Al Wabel College of Pharmacy and Dentistry, Buraydah Private Colleges, Saudi Arabia
Received 3 March 2015; accepted 15 March 2015
Peer review under responsibility of King Saud University.
Production and hosting by Elsevier http://dx.doi.org/10.1016/j.jsps.2015.03.019 This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Please cite this article in press as: Adnan, M. et al., Critical errors found during metered dose inhaler technique demonstration by Pharmacists. Saudi Pharmaceutical Journal (2015), http://dx.doi.org/10.1016/j.jsps.2015.03.019
King Saud University
Saudi Pharmaceutical Journal www.ksu.edu.sa www.sciencedirect.com
Critical errors found during metered dose inhaler technique demonstration by Pharmacists It is extremely important to demonstrate the standardized recommended technique (Adnan et al., 2014) of metered dose inhaler to the patients. Many studies have found critical errors made by pharmacists during demonstration of metered dose inhaler technique (Adnan et al., 2014; Osman et al., 2012; Lenney et al., 2000). The critical errors are those missing steps that have significant effect on aerosol drug delivery (Osman et al., 2012; Lenney et al., 2000). Missing these critical steps can lead to either little or no drug delivery to the target point (Lenney et al., 2000). Moreover, many studies have shown that as many as 25% of patients with asthma and COPD have never received verbal inhaler technique instruction (Javorini et al., 2008). The following critical steps have been found missing by pharmacists during demonstration of metered dose inhaler technique (Adnan et al., 2014; Osman et al., 2012; Lenney et al., 2000). Shake inhaler and remove the cap. Insert the mouthpiece into mouth between closed lips. Actuation in the first half of inhalation and at the same time breathe in slowly for deep inhalation. Hold breath for 10–15 s. These critical errors have been associated with increase in emergency visits, and worsening asthma (Giraud and Roche, 2002). Pharmacists are ideally positioned to teach inhaler technique as they are the last health-care providers however; they should review their inhalation technique and must be fully aware of appropriate recommended steps of using metered dose inhaler.
References Adnan, M., Karim, S., Khan, S., Al-Wabel, N.A., 2014. Comparative evaluation of metered-dose inhaler technique demonstration among community pharmacists in Al Qassim and Al-Ahsa region, Saudi-Arabia. Saudi Pharm. J. http://dx.doi.org/10.1016/ j.jsps.2014.06.007. Javorini, F., Magnan, A., Dubus, J.C., et al., 2008. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Resp. Med. 102, 593–604. Lenney, J., Innes, J.A., Crompton, G.K., 2000. Inappropriate inhaler use: assessment of use and patient preference of seven inhalation devices. Resp. Med. 94 (5), 496–500. Giraud, V., Roche, N., 2002. Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability. Eur. Resp. J. 19, 246–251. Osman, A., Ahmed Hassan, I.S., Ibrahim, M.I.M., 2012. Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study. Pharm. Pract. (Internet) 10 (2), 110–115.
Muhammad Adnan * Shahid Karim Shamshir Khan Naser Al Wabel College of Pharmacy and Dentistry, Buraydah Private Colleges, Saudi Arabia
Received 3 March 2015; accepted 15 March 2015
Peer review under responsibility of King Saud University.
Production and hosting by Elsevier http://dx.doi.org/10.1016/j.jsps.2015.03.019 This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Please cite this article in press as: Adnan, M. et al., Critical errors found during metered dose inhaler technique demonstration by Pharmacists. Saudi Pharmaceutical Journal (2015), http://dx.doi.org/10.1016/j.jsps.2015.03.019